Think.Thrift.Create

Tidbit Tuesday: Affordable Care Act 101/No Take Backs!

This was supposed to be a post on what to expect if you’re uninsured and looking to check out what the Affordable Care Act might have to offer you as federal and state insurance exchanges opened their virtual doors today. Don’t worry, I promise I’ll be back with a post to share what I know about the exchanges and my own personal experience setting up an account today. If you’re interested in looking for insurance please visit https://www.healthcare.gov/. If you’re interested in my thoughts on the recent shenanigans in Congress, read on.

The most vexing thing

If you’re anything like me, this morning you woke up with a bitter taste in your mouth because of the sorry state of American politics. Members of Congress, once again, decided at the 11th hour to pit the American people against themselves all in an effort to defund the Affordable Care Act. That’s right. They spent all that time and effort on the pretense of trying to take money from legislation already passed and funded instead of passing a budget. Riddle me that, as my Aunt Boo would say.

Millions of federal workers are once again furloughed but don’t get it twisted, their furlough is not because the Affordable Care Act has come, stealing their paychecks and benefits like a thief in the night. Oh no, in case you missed it, state and federal exchanges, ironically, are open for business today, as they should be, even if our federal government is not. Members of Congress are the only ones who stole from federal employees — fellow Americans, taxpayers — last night. For three years these members have tried to kill this legislation. For three years they were unsuccessful.

Let’s be clear. Congress didn’t shut down the government because of the Affordable Care Act, which it already funded. Congress shut down the government because of a repeated failure to pass a budget. A failure to do one of the central things Congress is supposed to do. The Affordable Care Act was used as a political foil. If it had not been the Affordable Care Act it would have been something else. In fact, when Congress has to deal with the debt ceiling pop some popcorn. The performances will be equally legendary, I’m sure.

Regardless of what anybody thinks, the opponents of the Affordable Care Act lost the battle against that piece of legislation when it was passed by a bipartisan effort. Bipartisan. Last I heard, that means both Republicans and Democrats voted for the dang thing three years ago. And I am calling no take backs! The Affordable Care Act was a compromise piece of legislation, which means no one got exactly what they wanted when that bill was passed. As a lobbyist — yes, a lobbyist — once told me when I was covering state government and politics in Alabama, never sacrifice the good for the great when it comes to legislation. It is debatable that the Affordable Care Act is even all that good given the assumptions it makes about access to a computer, literacy, money to spare and even time off to sort through the plans. But that is another post for another day.

Great in my mind would have been more than a promise of access to insurance and a patient’s bill of rights of preventative care. But if I can’t have great, I will take the Affordable Care Act, warts and all. Why? Because I am us and them. I am the very people being pitted against themselves, all so some politician can go home to his constituents — increasingly just the man in the mirror, I’m guessing — and say he has represented their interests. Politics are indeed local.

“Hello. I am an uninsured, federal contract worker.”

Don’t know anyone who is uninsured? Now you do. I am uninsured. Don’t know someone who is an employee, or federal contractor who will be directly impacted by the shutdown? Now you do. I will be impacted by the shutdown. I don’t begrudge anyone tucked away in the security of their private industry job, with their health care and benefits. I don’t because until June 15, I was one of you and I know for the vast majority of you those benefits are considered a part of your salary, not something paid above it.

But when my industry started to look shaky — downsizing employees and furloughing every quarter — the idea of working for myself became more and more appealing even as I considered the risks. The biggest risk for me, after being sure that I could eat and had a warm place to sleep, was health insurance. And what I saw in the private market was not encouraging. If I managed to find a plan that let me pay $100 a month for private insurance, my deductible could be as high as $10,000. If I paid more each month — a lot more — I might be able to get my deductible down to $2,500. And that is just health insurance. It doesn’t include eye and dental insurance, both of which mean a heck of a lot to a girl who has worn glasses since fifth grade and who sees her dentist more than any other doctor she’s ever had.

Access: Close, but no cigar

Increasingly, in this age of small start ups and more self-employed people, finding ways to afford healthcare is necessary and acute. The private insurance market won’t go away, but it is yet to be seen whether the Affordable Care Act will create enough competition to ensure that those of us who aren’t eligible for Medicaid and Medicare can get a foot in the door. But even I know I am writing out of the privilege of being a woman who has access to a computer, has a master’s degree and time to sort through Virginia’s health exchanges today such as they are.

You see I have the privilege of living in one of the states that had the arrogance to opt-out of creating its own exchange, thus leaving me and others like me with limited access. Not only do uninsured Virginians have fewer choices, they’ll also have less help. The Commonwealth of Virginia, with it’s smart self, opted out of creating an exchange and got a whopping $1.6 million for its efforts. That money funds the 16 navigators who will help hundreds of thousands of people in this state figure out this mess. Just across the border in Maryland, where the governor embraced the coming changes, sits a cool $150 million in federal funds to figure things out. I’m thinking about moving, but even that is my privilege talking because not everyone will be able to escape. Sadly, I suspect that Virginians have it better than residents of some of the other states that opted out. Alabama, I am looking at you.

How members of Congress sleep at night, I’ll never know. Maybe sleeping on the piles of money that represent their salaries and all that universal healthcare they receive at the expense of the American people makes it all bearable. But I’ll say this, nobody likes a sore loser. The fact that the opponents of Obamacare refuse to even attempt to be good sports about losing is disgusting and pathetic. If a Little League game ended this way, everyone playing would be forced to go to bed without their supper, and possibly be made to forfeit the season. But this isn’t Little League. This is real life and maybe if the players in Congress had to suffer more of the consequences of a shutdown, they’d get their real work — the work of passing an actual budget — done quickly and go home quietly.

— Ricks

***Next week I promise to share any insights I learn from trying to sign up for an insurance plan along with the information I learned from a forum hosted by Congressman Jim Moran, D-Alexandria.